Breast Cancer: Early Detection and Treatment

Breast Biopsy and Cancer Diagnosis

When a suspicious area is detected, a biopsy should be performed to obtain a definitive diagnosis.

• Fine-needle aspiration (FNA) – performed using a simple syringe, but may not always provide a clear diagnosis.

• Core needle biopsy – offers a much higher probability of an accurate diagnosis and requires local anesthesia.

Biopsy can be performed under ultrasound, MRI, or mammography guidance.

• When conducted with mammography, it is called stereotactic biopsy.

Surgical Diagnosis Methods

If needle biopsy is inconclusive, traditional surgical biopsy may be necessary, including:

• Direct excision of the suspicious tissue.

• Wire localization biopsy, performed under mammography or ultrasound guidance, followed by surgical removal.

Frozen Biopsy for Immediate Diagnosis

For patients with highly suspicious breast lesions, frozen section biopsy can be performed under general anesthesia.

• The suspicious tissue is surgically removed and immediately examined by a pathologist.

• If results indicate benign tissue, the biopsy incision is closed.

• If results confirm malignancy, surgery continues to remove the cancerous tissue.

Breast Cancer Surgery and Treatment

There are two main surgical approaches for breast cancer:

1. Breast-conserving surgery – removing the cancerous area with wide margins to prevent recurrence.

   • If there is risk of spread to the lymph nodes, they are also removed.

2. Mastectomy – complete removal of the breast.

Previously, axillary lymph nodes were routinely removed in all cases, but sentinel lymph node biopsy is now commonly used:

• A radioactive tracer or dye is injected to identify the first lymph node affected by cancer.

• If cancer is absent in the sentinel node, further axillary lymph node removal is unnecessary.

• If cancer has spread, axillary lymph nodes are removed in the same procedure.

Breast Reconstruction and Cosmetic Procedures

In cases where the breast is partially or fully removed, suitable patients may undergo:

• Silicone breast implants,

• Oncoplastic surgery,

• Reconstruction using tissue flaps,

• Breast reduction or augmentation surgery.

All of these procedures are performed by highly trained breast surgeons with specialized experience.